USREIA Report Request Authorization Form

U.S. Real Estate Association Inc

Upon Completion, Fax this request to: 866.271.2570   www.TenantScreen.org

 

(PLEASE PRINT CLEARLY AND FILL OUT COMPLETELY)

 

Applicant Name:___________________________ SSN#:_______-______-__________ DOB: ____/____/___

 

Address:___________________________________________________________ APT # _______________

 

City: ____________________________  State:___________   Zip: _______________________

 

Drivers License # if Requesting Motor Vehicle Report:___________________________________________

 

Former Address ( if NOT at present address for 2 years ):

Address: _________________________________________________________ APT # ________________

 

City: ____________________________ State: ___________  Zip: _______________________

 

I / We authorize the landlord named below to obtain a credit report, criminal report, and or eviction check, on me  through US Real Estate Investors Association Inc.

 

Applicant Signature:_____________________________     Date:____/_____/200__

 

To be Completed by US Real Estate Association Member ONLY

 

USREIA Membership#:      AC WEB           Requested by: ______________________________________

 

Contact Phone Number for Questions on Application:     (______________)____________-______________

 

Respond by Fax to (____________)_________________-___________________

 

Please Circle the Appropriate Requested Report(s)

 

Credit Report from:       Equifax             TransUnion                 Experian

Criminal Check:              National                       State

Other Background Check:        Eviction              SSN Search         Motor-Vehicle Report    

Business Report            

Pre Employment Credit Report:    Equifax        Trans Union         Experian

 

***  DO NOT forget to include a copy of Applicant(s) State Issued Drivers License / State Issued Identification Card.